Gastric ulcer clinical symptoms

Written by Zhu Dan Hua
Gastroenterology
Updated on March 10, 2025
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Gastric ulcers are a common clinical manifestation, with diverse symptoms. Typical symptoms include abdominal pain, bloating, nausea, vomiting, or early satiety. Typically, the abdominal pain is more noticeable after eating and presents as postprandial abdominal pain, but it can naturally subside after several hours. Of course, when accompanied by complications such as decreased appetite, nausea, and vomiting, it can manifest as vomiting blood or bloody stools, with the stools often being loose and black in color. Therefore, clinically, if you encounter situations like bleeding stools or vomiting blood accompanied by abdominal pain, ulcers should be considered, and it is recommended to seek timely treatment at a local hospital. If these conditions are relatively stable, they can be managed with medication.

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Causes of gastric ulcers

Gastric ulcers refer to inflammatory defects in the gastric mucosa, with several common causes as follows: First, infection with Helicobacter pylori is directly related to the development of peptic ulcers. Second, various drugs that damage the gastric mucosa, such as non-steroidal anti-inflammatory drugs, corticosteroid hormones, etc. Third, dietary factors. Long-term alcohol consumption, spicy foods, strong tea, and coffee can all cause gastric ulcers. Fourth, the digestive actions of gastric acid and pepsin damage the gastric mucosa, leading to a decline in the protective barrier function of the mucosa and causing ulcers. Fifth, abnormalities in gastric motility and decreased emptying ability, leading to food retention in the stomach, continuously irritating the gastric mucosa, causing increased gastric acid secretion and resulting in ulcers.

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Precautions for Gastric Ulcer

Patients with gastric ulcers should pay more attention to rest, reduce mental stress, and, moreover, enhance health education, maintain regular eating habits, have meals at fixed times and in fixed amounts, eat less greasy, spicy, and irritating food, strictly abstain from smoking and drinking alcohol, and drink less strong tea, coffee, and other such beverages. Actively use medical treatment, commonly using medications that suppress stomach acid secretion and protect the gastric mucosa. To achieve ulcer healing, the course of acid-suppressing medication generally lasts 4 to 6 weeks. One should maintain a relaxed mood, as excessive tension and anxiety can aggravate ulcer symptoms. Through effective medical treatment, the cure rate of peptic ulcers can reach over 95%. Even after healing, strict attention must be paid to dietary habits. (Please use medication under the guidance of a doctor.)

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Complications of gastric ulcers

The main complications of gastric ulcers are fourfold: one is upper gastrointestinal bleeding; the second is perforation; the third is pyloric obstruction; the fourth is malignant transformation. Upper gastrointestinal bleeding is the most common complication of gastric ulcers. If a patient has experienced bleeding, there is a high likelihood of recurrence. Perforations mainly occur in elderly individuals. Pyloric obstruction is primarily caused by ulcers in the pyloric canal and pre-pyloric area. It is divided into mechanical obstruction and functional obstruction. Mechanical obstruction results from scarring after the ulcer heals, which narrows the pyloric opening. Functional obstruction is due to congestion and edema of the mucosa after the ulcer, causing relative narrowing of the pylorus. As for malignant transformation, it is still controversial, but it is generally believed to be around 1%-7%.

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Does gastric ulcer require hospitalization?

Whether a stomach ulcer requires hospitalization depends on the condition. For minor ulcers, if the pain is mild and there are no significant symptoms of vomiting or nausea, treatment can be managed with medication, such as drugs that inhibit stomach acid secretion and protect the gastric mucosa. It is also important to regulate diet, eat soft foods, avoid cold, spicy foods, and alcohol, as symptoms can gradually ease. If the ulcer is larger and exhibits perforation or bleeding, hospital treatment is necessary, usually involving a significant portion of the stomach being surgically removed to completely cure the ulcer. (Medication should be taken under the guidance of a doctor.)

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Medications for treating gastric ulcers

Here I will introduce several major types of medications for treating gastric ulcers, but specific medication use should be consulted with a doctor or pharmacist according to individual conditions. The first major type is anti-gastric acid medications. Since gastric acid plays a significant role in ulcerative lesions, it is considered appropriate to treat gastric ulcers by adjusting the stomach environment to a pH of 3.5. Anti-acid medications include antacids, H2 receptor antagonists, proton pump inhibitors, and others. The second major type is gastric mucosal protectants, which include some class B drugs, prostaglandin derivatives, and some containing sucralfate. The third major type is medications that treat Helicobacter pylori, with quadruple therapy currently being a common practice. Note: Medications should be used under the guidance of a doctor.